Healthcare Provider Details
I. General information
NPI: 1215466156
Provider Name (Legal Business Name): MADELINE MARGARET JARY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/05/2017
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
230 W MONROE ST STE 100
CHICAGO IL
60606-4701
US
IV. Provider business mailing address
1 EMBARCADERO CTR STE 1900
SAN FRANCISCO CA
94111-3723
US
V. Phone/Fax
- Phone: 888-663-6331
- Fax: 415-252-7176
- Phone: 888-663-6331
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 085008536 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 5601008272 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: